Use of Intra-Aortic Balloon Pump in High Risk Coronary Patients for CABG

Objective: The aim of the study is to evaluate the efficacy and the benefit of IABP treatment on postoperative cardiac performance, mortality and morbidity and the optimal timing for its insertion for high risk patients undergoing coronary artery bypass surgery in a controlled prospective randomized manner. Material and Methods: This is a prospective study includes sixty randomized high-risk patients of both sexes with coronary artery disease who are scheduled to coronary artery bypass grafting done in Benha University Hospitals, Aswan Heart Center and Nasser Institute between Feb. 2013 and Feb. 2015. The patients included were those high risk patients who underwent Isolated CABG procedure; all patients should have one or more of the following criteria: (Left main disease >70%, E.F <35%, redo CABG, unstable angina at the time of surgery). Patients were divided into 2 equal groups: Group I contains 30 high risk patients who will have preoperative IABP, and Group II of 30 high risk patients with no preoperative IABP therapy. They either didn't receive IABP at all, or received IABP postoperatively in theatre or after transfer the patient to ICU. The decision to put an IABP was made by the individual surgeon operating the patient. Preoperative, intraoperative, and postoperative variables were recorded. Results were subjected to statistical analysis. Results: Forty seven patients (78.3%) were males while Thirteen (21.6%) were females with a mean age of 58.0 ±6.29 years. Patients who received preoperative IABP had shorter ICU stay (p=<0.001) and shorter hospital stay (p=0.001), also they showed lower hospital mortality (p=0.05) and decreased rate of postoperative arrhythmias ( p=0.036), decreased rate of perioperative MI (p=0.05), and less requirement for postoperative inotropic support (p=0.001) compared to those who did not receive IABP preoperatively. Conclusion: The prophylactic use of IABP in high risk patients undergoing CABG not only decrease the mortality but also has a favorable effect on postoperative major complications. Correspondence to: Dr. Bassem Gadallah, The Department of Cardiothoracic Surgery, Faculty of Medicine, Benha University